ABSTRACT
The macula is a common site of symptomatic retinal pathology requiring vitreoretinal intervention. Posterior vitreous detachment (PVD) is implicated in the production of the most common vitreoretinal macular disorders. Patients' symptoms consist of blurred vision or distortion. In the early stages, the patient sees a small central grey patch in their central vision, and because the receptors are not yet displaced, distortion of the image is usually absent. Distortion becomes a feature as the fovea splits apart and the photoreceptors are moved outwards onto the rim of the hole. The Gass grading system is still used to describe macular holes because it provides a guide to surgical success and visual outcome. Optical coherence tomography (OCT) is essential for confirming the diagnosis and to examine the other eye. OCT images discriminate partial thickness lamellar 'holes' and pseudoholes from full-thickness macular holes. The patient notices a blur of the vision, distortion and macropsia as the membrane contracts the retina centrally.
